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Bandwagons in colorectal surgery.
Daniel M Felsenreich1, Mahir Gachabayov1, Fabio Cianchi2
1Department of Surgery, New York Medical College, Valhalla, NY, USA.
Minerva Surgery
|December 13, 2022
Summary
Unproven medical trends, known as bandwagons, persist in colorectal surgery despite lacking evidence. Critical evaluation by innovators, trials, media, and physicians is crucial to prevent premature adoption of new surgical techniques.
Area of Science:
- Medical innovation and surgical trends
- Evidence-based medicine in practice
Background:
- Medical progress is sometimes hindered by unproven popular ideas, termed bandwagons, dating back to 1979.
- These trends, though occasionally valid, are often abandoned or replaced by newer bandwagons.
- Colorectal surgery currently faces at least five ongoing bandwagons, including laparoscopic lavage, laparoscopic ventral rectopexy, stapled hemorrhoidopexy (PPH), watch and wait, and transanal total mesorectal excision (taTME).
Purpose of the Study:
- To identify and discuss prevalent bandwagons in colorectal surgery.
- To emphasize the need for critical evaluation of new surgical trends.
- To outline strategies for preventing the premature adoption of unproven medical ideas.
Main Methods:
- Review of historical and current trends in surgical innovation.
- Identification of specific examples of bandwagons in colorectal surgery.
- Analysis of factors contributing to the adoption and rejection of medical trends.
Main Results:
- Several popular but unproven ideas, or bandwagons, are currently influencing colorectal surgery.
- These include laparoscopic lavage, laparoscopic ventral rectopexy, stapled hemorrhoidopexy (PPH), watch and wait protocols, and transanal total mesorectal excision (taTME).
Conclusions:
- Preventing the unchecked spread of bandwagons requires a multi-faceted approach.
- Innovators must prioritize evidence generation, and clinical trials must rigorously assess new treatments before widespread implementation.
- Physicians and media play vital roles in critically evaluating new ideas and avoiding the premature acceptance of unproven surgical techniques.
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